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- Anthony DeMaria, MD, MACC, Editor-in-Chief, Journal of the American College of Cardiology⁎ ()
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:Dr. Anthony N. DeMaria Editor-in-Chief, Journal of the American College of Cardiology 3655 Nobel Drive, Suite 630 San Diego, California 92112
Although not absolutely mandatory, it is a fact that nearly all manuscripts undergo revision in the process of peer review. In fact, of the nearly 40,000 manuscripts that we have reviewed, I cannot recall a single one that was accepted without at least some revision, and I can count on my fingers the number that have been recommended by even one reviewer for unrevised acceptance. However, the process of revision is often poorly understood and is a frequent source of questions. Having written previously about the preparation and review of a manuscript, I thought that the topic of revision deserved some consideration.
Medical journals differ in the categories utilized for the initial decision. At JACC we have tried to limit ourselves to three: 1) provisional acceptance; 2) rejection; or 3) de novo rejection with the offer to resubmit a revision under the same conditions as the initial submission. Our provisional acceptance letters may read as either “will” or “may” be acceptable, which correlate generally to the need for minor or major revision, and are associated with a 98% and 90% acceptance rate, respectively. It is rare that a provisional acceptance results in an ultimate rejection. Similarly, while we occasionally consider appeals of rejection decisions, it is infrequent that they result in a reversal of the initial evaluation.
In contrast to the other decision categories, de novo rejection often results in a final acceptance, but is frequently the source of confusion. Although the de novo decision is a rejection, such manuscripts contain sufficient novelty or potential importance that we want to provide the opportunity for revision. Usually this requires additional experiments. We have found that the acceptance rate for de novo resubmissions of nearly 50% is substantially higher than our overall rate of approximately 10%. Nevertheless, since the revised manuscripts are considered in competition with all other submissions, they may be rejected due to priority despite addressing all the concerns in the critiques. Needless to say, this may result in some unhappy authors. However, we believe that being given a “second chance at bat” is preferable to rejection, and have found that authors will almost universally choose this option when given the choice.
From time to time I am asked how best to prepare a revised submission. Based upon our experience and discussion with other editors, some principles have become evident. To begin with, a revised manuscript should generally be resubmitted as quickly as possible. A long delay in resubmission suggests that some problem may be present, or that the paper is not of very high importance for the author. The latter impression often tends to result in a proportionately reduced enthusiasm on the part of the reviewers and editors.
In preparing a revision it seems relatively obvious that one should not criticize or enter into a strident argument with the reviewers. If there is a heated disagreement regarding some aspect of the study, the reviewer can conclude that either he or she is wrong or the authors are wrong. The conclusion reached is usually predictable. Having said this, it is clearly not necessary for the authors to concede every issue to the reviewer if they firmly believe that they are correct. Reviewers are consultants to the editors, and the editors will adjudicate disagreements in favor of the author if the rebuttal is compelling. The important point is to make the rebuttal compelling and courteous. Along the same lines, revisions that are excessively flattering or obsequious are unlikely to impress either reviewers or editors.
In preparing a revision, attention should be paid to each individual comment. If additional data are requested, they should be provided if at all possible. All information generated in response to the critiques should be included in both the manuscript and the rebuttal letter. Recommendations for alterations in analysis, tone, or length of the manuscript should generally be carried out. However, here again the authors do not have to be blind slaves to the reviewers. We have frequently seen instances in which reviewers have said that the current study is good, but that “the study they should have done is.....”. As a rule, we feel that the study submitted is the one that should be judged; if the reviewers want another, they should perform it themselves.
The JACC editors have found that the best prepared revision letters all follow the same general format. The first step is to restate the issue or question raised by the reviewer. The response to each issue generally begins with a statement of agreement, disagreement, or some level of distinction, unless it is just an answer to a question. Obviously, if there is disagreement a rebuttal is provided. If agreement exists, the response to the specific concern is then described in detail. Finally, the specific change(s) to the manuscript in response to the specific issue is/are delineated. This last step is best done by directly providing in the letter the revised section of the manuscript with the alterations highlighted. In this way, the revision letter makes clear for both reviewers and editors the issues raised, the reply, and the changes made to the manuscript. Such revision letters convey a sense of attention to detail and completeness, and of course make it easy for the reviewers and editors to assess the adequacy of the revision.
As with the initial submission, the editors will generally forward the revised manuscript and rebuttal letter to the reviewers as well as evaluate it themselves. Although the editors can often assess the adequacy of the revision themselves, the opinion of the reviewers is useful and it is a courtesy to give them the opportunity to evaluate the response. Not surprisingly, the reviewers commonly detect issues upon re-review that were missed on the first round. We believe that responding to all evaluations results in a substantially improved manuscript.
Manuscript revision has become so ingrained in the peer-review process that it has come to be expected. Although we try to ensure constructive and courteous critiques, and usually redact insulting ones, occasionally offensive comments do get forwarded to the authors. In such conditions, we can understand an angry response. However, in general, we value revised manuscripts that are promptly submitted, with detailed replies to each of the issues raised and with the manuscript changes introduced in response to each issue well delineated in the rebuttal letter. We recognize that the process of revision takes time and delays the publication of the paper. However, we are convinced that a revised manuscript that includes a detailed and complete response to a constructive and thoughtful review will always result in a superior publication.
- American College of Cardiology Foundation